D88. High-volume Fat Grafting with and without Goldilocks Mastectomies Show Successful Clinical Outcomes for Breast Reconstruction

PURPOSE: There remains a paucity of literature examining high volume FG for total autologous breast reconstruction. We report a single surgeon's experience using fat grafting with and without Goldilocks mastectomies. METHODS: A retrospective review evaluated patients who underwent breast reconstruction with FG only or combined Goldilocks and FG. The minimum follow-up period was 4 months. Data was collected concerning the timeline of reconstruction. RESULTS: Our population included 39 breast reconstructions in 25 patients. Nineteen patients (28 breasts) had FG only and 6 patients had Goldilocks and FG (11 breasts). The FG only group averaged 4 grafting sessions while the Goldilocks combined group averaged 2.64 sessions (p=0.03). In the FG only group the average total volume injected was 663.61 mL, compared to 495.45 mL in the Goldilocks combined group (p=0.111). A comparable volume of fat was injected in the first five sessions, with a significant drop at the sixth session (p=0.013). There were four FG related complications and three seromas following Goldilocks mastectomies. CONCLUSION: High volume FG is a successful form of breast reconstruction and achieves good volume with minimal procedures necessary, especially when combined with Goldilocks mastectomies. This study depicts a reliable timeline for this understudied reconstructive option.